Prosthetics socket that incorporates an air splint system focusing on dynamic interface pressure

An adaptive prosthetic socket for people with transtibial amputation

It is essential that people with limb amputation maintain proper prosthetic socket fit to prevent injury. Monitoring and adjusting socket fit, for example by removing the prosthesis to add prosthetic socks, is burdensome and can adversely affect users' function and quality-of-life. This study presents results from take-home testing of a motor-driven adaptive socket that automatically adjusted socket size during walking. A socket fit metric was calculated from inductive sensor measurements of the distance between the elastomeric liner surrounding the residual limb and the socket's inner surface. A proportional-integral controller was implemented to adjust socket size. When tested on 12 participants with transtibial amputation, the controller was active a mean of 68% of the walking time. In general, participants who walked more than 20 min/day demonstrated greater activity, less doff time, and fewer manual socket size adjustments for the adaptive socket compared with a locked non-adjustable socket and a motor-driven socket that participants adjusted with a smartphone application. Nine of 12 participants reported that they would use a motor-driven adjustable socket if it were available as it would limit their socket fit issues. The size and weight of the adaptive socket were considered the most important variables to improve.

Performance of an auto-adjusting prosthetic socket during walking with intermittent socket release

Introduction

A challenge in the engineering of auto-adjusting prosthetic sockets is to maintain stable operation of the control system while users change their bodily position and activity. The purpose of this study was to test the stability of a socket that automatically adjusted socket size to maintain fit. Socket release during sitting was conducted between bouts of walking.

Methods

Adjustable sockets with sensors that monitored distance between the liner and socket were fabricated. Motor-driven panels and a microprocessor-based control system adjusted socket size during walking to maintain a target sensed distance. Limb fluid volume was recorded continuously. During eight sit/walk cycles, the socket panels were released upon sitting and then returned to position for walking, either the size at the end of the prior bout or a size 1.0% larger in volume.

Results

In six transtibial prosthesis users, the control system maintained stable operation and did not saturate (move to and remain at the end of the actuator's range) during 98% of the walking bouts. Limb fluid volume changes generally matched the panel position changes executed by the control system.

Conclusions

Stable operation of the control system suggests that the auto-adjusting socket is ready for testing in users' at-home settings.

Design and Fabrication of a New Expandable Transtibial Liner with Manual Volume Control: A Prototype

Diurnal volume changes is one of the main factors influencing socket fit in transtibial prosthesis and causing pressure problem issues. Embedded bladder liners have been recently a potential approach to deal with this problem. The aim of this technical note was to introduce a new transtibial silicone liner designed based on hybrid socket theory.

To make expandability in the liner, an integrated wax structure was constructed over the selected areas of the positive model and then removed after lamination process. In addition, a mechanical system with manual control was designed to fit the liner with the residual limb volume by pumping the water in or out of the liner through connective tubes.

The results showed that this new design had high reliability in maintaining identical surface pressures after volume changes in laboratory trials. Therefore, it seems that selective expandability of this liner would accommodate residual limb volume fluctuations without disturbing effect on preliminary pressure pattern.

An Adaptive Socket Attaches onto Residual Limb Using Smart Polymers for Upper Limb Prosthesis

A major challenge for upper limb amputees is discomfort due to improper socket fit on the residual limb during daily use of their prosthesis. Our work introduces the implementation of soft robotic actuators into a prosthetic socket. The soft actuators are a type of electrically-powered actuator. The actuator is driven through changes in internal temperature causing actuation due to vapor pressure, which results in high and reliable force outputs. A regression fit was generated to model how the smart polymer's temperature relates to force output, and the model was cross-validated based on training data collected from each actuator. A proportional integral (PI) controller regulated the force exerted by the actuators based off of tactile and temperature feedback. Results showed that a socket system can be integrated with smart polymers and sensors, and demonstrated the ability to control two actuators and reach desired forces from set temperatures.

An adaptive socket with auto-adjusting air bladders for interfacing transhumeral prosthesis: A pilot study

Comfort is a critical aspect in the application of wearable device, such as rehabilitation robots and upper limb prostheses. As a physical interface between human body and prosthetic limb, the socket and its comfort largely contribute to the user's acceptance. Traditional sockets are static, lacking dynamic adjustment mechanism for the contact pressure. To ensure a reliable suspension during daily activities, the socket is usually designed to be tightly attached, with a large stress, on the residual limb, which may introduce considerable discomfort during long-term use. In this article, we present a novel adaptive transhumeral socket, in which we employ four independent bladders contacting with the stump. Not only can these bladders provide a necessary suspension for the device but also form an air cushion (soft body) that helps relieve the pressure concentration between the biological body and physical prosthesis. In real time, this adaptive socket continuously monitors the limb posture, the operating load, and the contacting pressure between the socket and the limb, and then dynamically adjusts the clamping force to ensure a reliable attachment during various daily activities. Since well adapting to the contours of the stump, the bladders can effectively accommodate the volume change of the stump, making a balanced load distribution on load-tolerant areas. Through modeling and numerical analysis, we established a dynamic strategy for estimating the external load and an automatic scheme for adjusting the bladders' air pressure. Finally, a close-loop control was constructed based on the contact pressure measured by our self-developed force sensors. Our preliminary experiments on one normal (i.e. non-amputee) subject verified the effectiveness of the proposed method, showing that the adaptive socket can considerably reduce the socket-limb contact pressure while sustaining a secure suspension on the upper arm.

Designing an Adaptive Prosthetic Socket Controller Using H-Infinity Loop Shaping Synthesis

Amputees often find wearing a prosthetic limb for a long period of time uncomfortable. Prosthetic sockets that adjust the socket's fit automatically, or adaptive sockets, would encourage amputees to wear their prosthesis more frequently. In this work, we simulate the control system design of a Multiple-Input, Multiple-Output (MIMO) adaptive socket using principles of optimal control and robust control. A data-driven model of the socket-limb interface is first obtained by applying regression to open-loop recordings of the socket interacting with the limb during a simulated grasping task. A MIMO controller is then designed to maintain a desired uniform socket fit. An $H_{\infty}$ controller, obtained from loop shaping synthesis using the Glover-McFarlane method, is shown to perform comparably to a Linear Quadratic Gaussian (LQG) controller while maintaining robustness to uncertainties in the socket-limb interface model. This work then outlines a potential procedure on how to develop the control system for a real adaptive prosthetic socket with multiple sensors and actuators.

Evaluation of Force Sensing Resistors for the Measurement of Interface Pressures in Lower Limb Prosthetics

Understanding pressure distributions at the limb-socket interface is essential to the design and evaluation of prosthetic components for lower limb prosthesis users. Force sensing resistors (FSRs) are employed in prosthetics research to measure pressure at this interface due to their low cost, thin profile, and ease of use. While FSRs are known to be sensitive to many sources of error, few studies have systematically quantified these errors using test conditions relevant to lower limb prosthetics. The purpose of this study was to evaluate FSR accuracy for the measurement of lower limb prosthetics interface pressures. Two FSR models (Flexiforce A201 and Interlink 402) were subjected to a series of prosthetic-relevant tests. These tests included: (1) static compression, (2) cyclic compression, and (3) a combined static and cyclic compression protocol mimicking a variable activity (Walk-Sit-Stand) procedure. Flexiforce sensors outperformed Interlink sensors and were then subjected to two additional tests: (4) static curvature and (5) static shear stress. Results demonstrated that FSRs experienced significant errors all five tests. We concluded that: (1) if used carefully, FSRs can provide an estimate of prosthetic interface pressure, but these measurements should be interpreted within the expected range of possible measurement error given the setup; (2) FSRs should be calibrated in a setup that closely matches how they will be used for taking measurements; and (3) both Flexiforce and Interlink sensors can be used to estimate interface pressures, however in most cases Flexiforce sensors are likely to provide more accurate measurements.

Dynamically Mapping Socket Loading Conditions During Real Time Operation of an Upper Limb Prosthesis

A continuing problem faced by amputees is that extended use of a prosthesis leads to discomfort along the residual limb. In this work, we use a novel pressure sensor array and an inertial measuring unit to monitor the changes in the pressure distribution within an upper limb socket in response to its position and the real time performance of a grasping task. These experiments illustrate that the operation of a prosthetic hand produces distinct features in the time derivative and spatial component of the sensor outputs, which correspond to the orientation and task-dependent changes in loading conditions within the socket. The significance of this study is that it highlights the use of a combined pressure sensor array and inertial measuring unit as a way to characterize the loading conditions within a prosthesis based on both temporal and spatial information during movement. This method of real time pressure sensing in prosthetic sockets will be useful for adaptive socket technology aimed towards decreasing the discomfort caused by long-term use of a prosthesis.

An anthropomorphic transhumeral prosthesis socket developed based on an oscillometric pump and controlled by force-sensitive resistor pressure signals

While considering the importance of the interface between amputees and prosthesis sockets, we study an anthropomorphic prosthesis socket whose size can be dynamically changed according to the requirements of the residual limb. First, we introduce the structure and function of the anthropomorphic prosthesis socket. Second, we study the dynamic model of the prosthesis system and analyze the dynamic characteristics of the prosthesis socket system, the inputs of an oscillometric pump, and the control mechanism of force-sensitive resistor (FSR) pressure signals. Experiments on 10 healthy subjects using the designed system yield an average detection result between 102 and 112 kPa for the FSR pressure sensor and 39 and 41 kPa for the oscillometric pump. Results show the function of the FSR pressure signal in maintaining the contact pressure between the sockets and the residual limb. The potential development of an auto-adjusted socket that uses an oscillometric pump system will provide prosthetic sockets with controllable contact pressure at the residual limb. Moreover, this development is an attractive research area for researchers involved in rehabilitation engineering, prosthetics, and orthotics.

Biomechanics principle of elbow joint for transhumeral prostheses: comparison of normal hand, body-powered, myoelectric & air splint prostheses

BACKGROUND

Understanding of kinematics force applied at the elbow is important in many fields, including biomechanics, biomedical engineering and rehabilitation. This paper provides a comparison of a mathematical model of elbow joint using three different types of prosthetics for transhumeral user, and characterizes the forces required to overcome the passive mechanical of the prosthetics at the residual limb.

METHODS

The study modeled the elbow as a universal joint with intersecting axes of x-axis and y-axis in a plain of upper arm and lower arm. The equations of force applied, torque, weight and length of different type of prosthetics and the anthropometry of prosthetics hand are discussed in this study. The study also compares the force, torque and pressure while using all three types of prosthetics with the normal hand.

RESULTS

The result was measured from the elbow kinematics of seven amputees, using three different types of prosthetics. The F-Scan sensor used in the study is to determine the pressure applied at the residual limb while wearing different type of prostheses.

CONCLUSION

These technological advances in assessment the biomechanics of an elbow joint for three different type of prosthetics with the normal hand bring the new information for the amputees and prosthetist to choose the most suitable device to be worn daily.